The Association Between Depression and Sexually Transmitted Infections During Pregnancy Among Underserved Pregnant...

Depression involves intertwining socioeconomic, behavioral, and health factors, creating a complex landscape for providers to address during pregnancy. Its association with social determinants of health and immunologic inflammation complicates its relationship with sexually transmitted infections (STIs). This study aimed to assess the association between depression and STIs among underserved pregnant patients.

A cross-sectional study was conducted of pregnant patients from February 2019 to May 2023 within a public health system. Medical records for patients undergoing pregnancy screening were reviewed. Demographic data, depression data, STI data, and obstetric outcomes were recorded. Patients with depression were identified through self-reports to providers and Edinburgh Postnatal Depression Scale scores of 10 or higher. A multivariable logistic regression model with robust error variance was used for analysis.

Among the 20,111 singleton pregnant patients studied, 1054 (5.24%) reported experiencing depression during pregnancy, and 3.2% were diagnosed with any STI. After multivariable adjustment, compared with patients without depression, those with depression had increased odds of having any STI (adjusted odds ratio, 1.54; 95% confidence interval, 1.20-1.99). Patients with depression had higher odds (adjusted odds ratio, 1.81, 95% confidence interval, 1.16-2.84) of having syphilis compared with those without.

Our findings exemplify an elevated association of STI, particularly syphilis, among underserved pregnant patients with depression.